不同保存时间对4℃储存全血凝血功能的影响

Effects of different lengths of storage on coagulation function of 4℃-stored whole blood

目的探讨不同储存时间全血凝血功能变化,为战创伤/应急全血输注提供科学依据。方法采集60 ml枸橼酸盐-磷酸盐-葡萄糖-腺嘌呤溶液(CPDA)抗凝全血25份,4℃冰箱储存,分别在储存第0、7、14、21、28、35天取样进行血栓弹力图(TEG)、血小板(PLT)计数、生化及其他血液学指标的检测。结果随着储存时间的延长,全血TEG R值变化不大;K值逐渐增大,在第28天高于正常值上限;Angle角逐渐减小,在第35天时低于正常值下限;MA值逐渐降低,在第28天时低于正常值下限。PLT计数逐渐降低,在第28天时低于正常值下限。生化及其他血液学指标中,白细胞(WBC)计数和Na^+逐渐降低;凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)逐渐升高;红细胞计数(RBC)、血红蛋白(Hb)、血细胞比容(Hct)、纤维蛋白原(Fbg)变化不大。结论全血在4℃储存21 d时,TEG MA值和PLT较新鲜全血虽有明显下降,但仍在正常范围之内,具备良好的凝血功能,可用于战创伤/应急输血救治。

Objective To investigate the changes in coagulation function of whole blood that is stored for different lengths of time,and to provide data for war wound/emergency whole blood transfusion.Methods Twenty-five copies of 60 ml of citrate-phosphate-dextrose-adenine solution(CPDA)anticoagulated whole blood were collected and stored at 4℃.Samples were taken at time points of 0,7,14,21,28 and 35 days for detection of thrombelastography(TEG),platelet(PLT)count,biochemical and other hematological indicators.Results With the prolongation of storage time,the TEG R value of whole blood did not change much.The K value gradually increased,and was higher than the upper limit of the normal value on day 28.The Angle and MA values gradually decreased,and were lower than the lower limit of the normal value on days(dd)35 and 28,respectively.The PLT gradually decreased,and was lower than the lower limit of the normal value on d 28.Among biochemical and other hematological indicators,white blood cells(WBC)and Na+gradually decreased,prothrombin time(PT)and activated partial thromboplastin time(APTT)gradually increased,but red blood cells(RBC),hemoglobin(Hb),hematocrit(Hct)and fibrinogen(Fbg)did not change much.Conclusion When whole blood is stored at 4℃for 21 days,the TEG MA value and PLT are significantly lower than those of fresh whole blood,but they are still within the normal range and can ensure good coagulation function,which can meet the demand of whole blood transfusion in emergency.